Despite being held to stringent weight and body fat standards, published research shows that one in five individuals from a sample of US military personnel from 2001 – 2008 have obesity. Further, shortly after separating from active duty, US military veterans are as likely to have obesity as civilians. Data from the research also showed an association between military personnel who have obesity – including both active duty and veterans – and mental health conditions like depression and posttraumatic stress disorder (PTSD). The research led by Toni Rush, was published in Obesity, the scientific journal of The Obesity Society.

The study, 'Obesity and associated adverse health outcomes among US military members and veterans: Findings from the millennium cohort study', comes at a time when the military is already presented with significant recruiting challenges and names obesity as one of the top reasons for military ineligibility among people ages 17 to 24. The researchers who conducted the study say the benefits of learning to maintain a healthy weight and proper nutrition go beyond time spent serving our country.

“Establishing lifelong healthy behaviors for active duty and veteran military personnel could not only ensure a fit force, but also reduce post-service-related costs for the Department of Defense, Department of Veterans Affairs and the US healthcare system,” said Rush, lead author of the study. “More importantly, it could enhance the quality of life for thousands of veterans.”

To conduct the study, Rush and colleagues examined data from 42,200 current and former military personnel from 2001 – 2008 as part of the Millennium Cohort Study. Of the 42,200 individuals, rates of obesity were significantly higher among veterans (32%) compared to service members (20%). Percentage of veterans with obesity did not change significantly between less than one year and more than three years after military separation, suggesting that the increase in obesity may occur shortly after separation.

In a cross-sectional analysis of the data, the researchers found that military personnel who had obesity had higher rates of depression and PTSD than individuals with normal weight (all p < 0.05). Hypertension, diabetes and sleep apnoea were also significantly more common among individuals with obesity (all p<0.05).

The study authors said they hope their study can be used to inform programs and policies that address obesity and overall health among US service members and veterans.

“These individuals are frequently put in harm’s way to protect our nation,” said Dr Catherine Champagne, member of The Obesity Society’s Advocacy Committee. “We count on our military to be in the best shape both physically and mentally, and these data show there is a need to improve efforts to maintain a healthy weight within our Armed Forces. Because military personnel – and especially veterans – make up a sizable portion of the U.S. population, this research is important to the overall health of the country. The findings show that even when equipped with the knowledge of how to implement healthy behaviours, it can be difficult to maintain a healthy weight when motivational drivers change. Given the associations of obesity and its complications, this should be seen as a national priority both for the American people and its military.”

Study limitations include that the analysis relies on self-reported data and that data was based on a random sample of Service members serving in 2000 (individuals who are now likely in their 30s and 40s), which may not be entirely representative of today’s military profile.

Additionally, in a commentary accompanying the paper, Drs Van Hubbard and Karl Friedl, mention that greater muscle mass in fitness-oriented service members, which is so prevalent in the military, may have affected some of the data related to individuals, especially the individuals classified as overweight.

“This Millennium Cohort Study dataset, with its longitudinal and prospective design, offers many opportunities for further analyses,” concluded Hubbard.